Workforce Performance Report April 2015 Jayne Halford Deputy

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Workforce Performance Report April 2015 Jayne Halford Deputy Director of HR Caring, safe and

Workforce Performance Report April 2015 Jayne Halford Deputy Director of HR Caring, safe and excellent 1

Headline HR KPIs Turnover – Target 12% - Actual 13. 33% Turnover has increased

Headline HR KPIs Turnover – Target 12% - Actual 13. 33% Turnover has increased slightly since last month which was at 13. 06%; the last time it was at this level was August /July 2014 which was the first time that turnover went above 13%. All Directorates other than Corporate are above 13%. Stability is at 83. 22% - at its lowest; Corporate has the lowest stability followed by Older Peoples Directorate. Sickness – Target 3. 5% - Actual 4. 32% Data from NHS 2014/15 FTN accounts for 338 Trusts shows average sickness at 4. 31%; this Trust was 153 rd out of those 238 Trusts. This month at 4. 32% is still at the average of that figure and has dropped from 4. 36% last month. Bank and Agency- Limit 5% Actual 4. 0% Bank and agency has dropped considerably since last month where we showed the likely effect of annual leave. However, use of sessionals has increased this month and at 3. 3% though has not been so high since April 2014. Use of sessionals was highest in Adult Services although bank and agency usage was also highest there. Vacancies: Limit 9% - Actual 6. 1% Headcount is down overall largely as a result of 2 TUPEs at the end of March. New starters exceeded leavers in terms of wte whereas in previous months leavers have outstripped starters on the whole. Headcount is at its lowest since August 2014 and before that October 2012. 2

Headline HR KPIs - Sickness Reasons After a fall in stress-related absence April saw

Headline HR KPIs - Sickness Reasons After a fall in stress-related absence April saw a significant increase again; colds, flu etc. not surprisingly fell as one would expect and the higher levels previously of seasonal sickness may have masked stress related absence. The Occupational Health slides report on the extra resource for musculo-skeletal issues but it is too early to attribute this month’s drop to that – we will monitor these figures in the next few months. In the last 12 months the Occupational Health service delivery model has been changed and 2 mental health practitioners have been employed. . In the last month of 16 referrals for perceived work related stress, 4 have been referred on for perceived work related counselling. This could mean that self-help strategies have been encouraged, the employee is already in the NHS system or counselling support is declined or not necessary. A Business case was submitted last year which followed the pilot stress management course, which was well received, no additional funding has been agreed to date and another submitted requesting additional funding to enable Counselling provision to increase however this has not been authorised and therefore OHD can only provide counselling for up to approx. 46 employees per year on the current budget. OHD and Healthy Minds attended the Ethics committee to explore the “fast track” position of employees within our own organisation and are exploring the provision of a separate service for mental health for OHFT employees. Length of Episode of Sickness This month has seen a significant increase in long-term sickness; the drop in short-term sickness accompanies the drop in episodes of colds, flu etc 3

Headline HR KPIs - Leavers The lack of information from the leaving process continues

Headline HR KPIs - Leavers The lack of information from the leaving process continues to hamper more in-depth analysis of reasons for leaving. Leaver forms are designed to capture the main reason for leaving but are often left blank. Managers are being asked to provide more detail. A breakdown of staff movement between bands shows that in the 12 months to end January 2015 there were 358 movements between bands – the largest percentage being quite significantly movement to Band 6 with movement to Band 5 and Band 7 also featuring – this equates to 5. 77% of the workforce. Qualitatively there is less information – only 11% of leavers so far in 2015 have completed exit questionnaires – but the data supports reasons for leaving , main ones being lack of promotion opportunities and relocation. As previously reported the majority of leavers stay within the NHS – nearly 40%. 4

 Directorate Performance – Headlines 5

Directorate Performance – Headlines 5

 Directorate Performance Older Peoples Directorate Turnover: 13. 93% v 12% Target • Minor

Directorate Performance Older Peoples Directorate Turnover: 13. 93% v 12% Target • Minor increase from last month’s figure of 13. 6% • A rolling turnover rate of 13% Community Hospitals resulted from 3 staff members leaving that service. Concern had been expressed in previous months about the turnover rate in Abingdon community hospital. However this month there were no leavers from Abingdon (2 from Wallingford, 1 from Didcot). • Rolling turnover in Community Nursing remains high at 19. 2% (an increase from 17. 7% last month). Concerns about workload / work life balance and support through PDR and supervision continue to be cited as reasons for leaving. The service are also looking at development opportunities to reduce turnover and improve retention. Discussion is also taking place with commissioners about ways to alleviate the pressures of workload within the service. • The service management are working with the Recruitment Team in HR to explore different approaches to recruitment including a “rolling” recruitment programme, recruitment open days and a speedier process for shortlisting candidates for interview. Following a request from the Community Nursing teams, the Recruitment Action Group will look at a proposal to extend contractual notice periods. Whilst this in itself will not reduce turnover, it would allow managers to recruit behind leavers in a more timely manner. It would also create parity with the OUH. Sickness: 5. 12% v 3. 5% Target • Slight reduction in sickness absence across the Directorate this month (from 5. 19%). • All long term sickness cases are being managed appropriately in accordance with Trust policy (33 cases in formal stage). The HR team have reviewed Bradford Factor scores and are assisting managers with cases of short term frequent absence as well as those on long term absence. The amount of management time is considerable. • The main reasons for absence in the directorate continue to be Anxiety and Stress and Musculoskeletal (MSK) problems. 6

Directorate Performance Older Peoples Directorate Contd. Bank and Agency – 2. 7% v 5%

Directorate Performance Older Peoples Directorate Contd. Bank and Agency – 2. 7% v 5% limit • • • Bank and agency spend is considerably reduced over last month. Recruitment in Community Hospitals and Community Nursing has resulted in increased staffing levels which is having a positive impact on bank and agency usage. The Agency Co-Ordinator is working with line managers to move lines of work to framework agencies. Governance implications of using non-framework agencies are being raised through CQC Taskforce Group Vacancies – 8. 8% v 9% limit • Community Hospitals – The vacancy rate is 11. 1%. The Recruitment Advisors report that vacancies at Abingdon are at an 18 month low following an increase in applications. Witney and Wallingford Community Hospitals are still experiencing difficulties. • Community nursing – The Recruitment Advisors report an increase in applications for posts in Community Nursing. As many of these are newly qualified nurses it will be some time until the new staff take up their posts and a further period until they become fully effective in post. The ILT management teams are preparing plans to manage this. 7

 Directorate Performance C&YP Directorate: Sickness 3. 01% v 3. 5% target The overall

Directorate Performance C&YP Directorate: Sickness 3. 01% v 3. 5% target The overall trend has continued to be below trust target. Sickness absence is being managed with support from Occupational Health; we have seen a number of successful returns to work plans. This month has seen a decrease in long term sickness in all areas, with the exception of Specialist Services and Complex Care. Anxiety/stress/depression/other psychiatric illness remains high but below the trust target. Turnover 13. 18% v 12% target We have seen an increase in turnover from last month of 0. 57%, however turnover remains lowest % across all Directorates except Corporate. Highest turnover is within Dental Services at 21. 3% (last month 20. 69%), followed by Swindon, Wilts and Banes at 17. 4% (last month 15. 97%) and Specialist Services at 13. 7% (last month 13. 42%). Bank & Agency 3. 7% v 5% target Agency accounts for 3. 6%. The only Bank use has been in Specialist Services. • CYP Specialist Services (includes 2 Oxford inpatient units) - Bank & Agency 8. 7% (last month 13. 95%). Agency is 8. 4% and Bank 0. 3%; HR is working with the Highfield via regular meetings with the manager and input regarding the agency framework and availability of lower cost agency staff. Due to difficulties in recruiting the required grade of staff currently 3 agency contracts of 6 month are in place on one of the inpatient wards to provide consistent support while further recruitment is in hand. • Complex Care Services – Bank and Agency -2. 1% all of which is agency recovery (last month 5. 55%). • Swindon, Wilts and Banes (includes 2 inpatient units) - Bank & Agency 2. 9% all of which is agency spend (last month 6. 12%); HR input is continuing to try to improve the availability and cost of agency provision. 8

 Directorate Performance C&YP continued: • Dental – Bank and Agency 0% (last month

Directorate Performance C&YP continued: • Dental – Bank and Agency 0% (last month 0. 55%) • CYP Management – Bank and Agency -0. 3% recovery (last month 0. 7%) Vacancies % v 9% limit The recruitment team have recently advertised and appointed to the student School Health Nurse, Health Visitor and SCHPN roles which has seen an increase in recruitment activity for the Directorate. An excellent recruitment process resulted in offers for 5 Staff Nurse Vacancies at Marlborough House, Swindon. Cotswold House, Oxford and the Highfield Unit are regularly amber on the safer staffing report, they both have 4 Staff Nurse vacancies and these are currently being advertised on NHS Jobs. Casework: HR are currently managing 7 formal cases (a decrease of 2 since last report), which consist of 2 disciplinary matters, 3 capabilities (2 of which related to Health), 1 Probationary and 1 Bullying & Harassment. Off the two cases removed, 1 is due to a resignation following completion of sickness absence and grievance process the other as a result of a successful return to work following formal sickness absence management. One performance capability is in abeyance until the individual returns from Maternity Leave. There are no ET claims. HR continues to work closely with managers, support is also being provided regarding informal matters some of which are of a complex nature. All formal cases have an appointed investigation manager with investigations underway. There is one suspension in the Directorate, which is kept under review. Change Management and General • The Directorate has been successful in retaining the contract to provide CAMHS services within Buckinghamshire. HR continues to support the Directorate in the implementation of the new service model associated with this re-provisioning. • HR are working as part of the overall project team involved in collating the Trust complication of its response to the Wiltshire tender. • HR delivered a half day overview of performance management principles and practices to Band 7 Childrens integrated therapy employees. 9

Directorate Performance Adult Services Directorate Turnover – 13. 9% v 12% limit Turnover is

Directorate Performance Adult Services Directorate Turnover – 13. 9% v 12% limit Turnover is over the KPI in most areas. The historical and repeated reason for the turnover for Psychological Therapies has been reported previously. Since September staff have been leaving Thames House as it is a difficult working environment with the current patient mix. There is an action plan in place to address the recruitment and retention issues in WELS. Sickness – 4. 4 % v 3. 5% limit Sickness is above target on three of the five clinical pathways. Longer term sickness cases are being managed with the support of Occupational Health and staff are returning to work. 10

Directorate Performance Adult Services Directorate ctd Bank and Agency – 5. 6% v 5%

Directorate Performance Adult Services Directorate ctd Bank and Agency – 5. 6% v 5% limit • There is high usage of agency staff in Bucks & Oxford clinical pathway to fill vacancies. There is Directorate support to use Bank & Agency appropriately due to difficulty recruiting staff nurses on inpatient wards and Band 6 CPN’s in the Community. Student Nurses and Health care Assistants were recruited at recent open days and will start when they complete their training and their employment checks. • Thames House is having particular difficulty in attracting qualified staff and there will be an increase in agency costs for the next 6 months. Discussions are taking place regarding patient mix which is impacting adversely on observations and escort duties. Vacancies – 7. 2% v 9% limit The vacancy level is at its lowest level since November 2013 as a result of intensive recruitment campaigns. HR is working closely and proactively with the Directorate to support the recruitment process. A careers day is planned for the 20 th June in Oxford for all professions and we have a recruitment drive starting in May for sessional staff who we believe will be attracted now the Trust can pay weekly putting us on an equal footing with NHSP. We are meeting weekly with Thames House managers to ensure their recruitment issues are high priority. 11

 Directorate Performance Corporate Directorates : Turnover 9. 76 % v 12. 0% Target

Directorate Performance Corporate Directorates : Turnover 9. 76 % v 12. 0% Target Turnover is low in Corporate services although stability is also low which means that employees stay for a shorter length of time. Turnover is highest in CEO Office and R and D however these are relatively small teams which can skew figures. Sickness 3. 53 % v 3. 5% Target Sickness absence has gradually been increasing in the Corporate services and is highest in Medical Directorate and Strategy and Development – again this latter is a small team and so figures are skewed. There have been a number of capability (health) cases resolved so we may see figures decrease again Bank & Agency 4. 1% v 5. 0% limit Bank and agency are high in Finance & Performance contracts and Strategy and Development, this latter also has a high percentage of vacancies. An audit of business requirements will take place in Strategy and Development to include reviewing staffing levels Vacancies 20. 91 % v limit 9% Vacancies appear high in Corporate but are skewed by, for example, additional funding for R and D which is not yet staffed and agency usage in Strategy and Development. Vacancies are high in Estates as posts have been held pending re-organisation in case any staff are at risk. Some IT posts are proving difficult to fill. General The restructuring of Estates and Facilities is ongoing and requiring support on process and changes to staff records. 12

Recruitment The number of live adverts has increased in April as the Trust is

Recruitment The number of live adverts has increased in April as the Trust is now recruiting for the various student/trainee posts that commence in September; in line with the increase of adverts the number of applications received has gone up. On the 1 st April 2015 the Care Certificate was introduced nationally; the certificate is intended to be one part of the induction for staff who are employed as healthcare assistants, care support workers and those giving support to clinical roles where there is any direct contact with patients. From the 1 st June 2015 all candidates who are appointed to or cleared to commence employment in an unregistered band 1 -4 clinical post are required to undertake the Care Certificate Programme in the first 12 weeks of employment. Candidates will be required to attend a one week induction programme at the Learning & Development Centre in Oxford prior to joining the clinical service. The Care Certificate induction will be held every three weeks so clinical services should not see a delay between a candidate being cleared and them being able to start with the Trust. Of the recruitments opened in April 42% of the jobs are qualified nursing and 18% are admin/clerical – whilst the admin % is in line with the staffing make up of the Trust the percentage nursing jobs being advertised is above as is the percentage for AHP jobs being advertised. 13

Recruitment Action Group The following areas are currently being addressed: • Improvement of external

Recruitment Action Group The following areas are currently being addressed: • Improvement of external web pages • Improvement to advertisements and attachments on NHS jobs • Incorporation of values into all recruitment material • Promotion of staff accommodation and key worker housing • Financial incentives • Improving links with Universities • Retention strategies and career development opportunities In addition a senior HR team has been scrutinising the recruitment process to look at areas of improving efficiency and reducing the recruitment cycle. A recruitment database is being built to help to deliver these efficiencies as well as enabling more accurate reporting. Values Based Interviewing A project to scope and implement value based recruitment started in May 2014 and a project plan was developed. This was benchmarked against best practise with NHS Employers and other Trusts across the country. A survey was conducted with a cross sample of staff and volunteers from across the Trust from which a Behavioural Framework has been developed. This framework received Board sign off in January 2015 and will form the basis of the values based interviewing as well as the PDR process. Interview questions have been developed and training material is currently being drafted. Managers will be trained in values based interviewing throughout 2015/16. 14

Casework There are currently 97 open cases – the largest number being Capability (ill-health)

Casework There are currently 97 open cases – the largest number being Capability (ill-health) issues. This represents 1. 58% of staff. There is a small overlap i. e in a few instances one employee is involved in both a capability or disciplinary process and a grievance. Casework duration continues to be managed down; the main obstacle being lack of investigator time, mainly due to conflicting priorities and the number of trained investigators particularly in Older People’s Directorate. Options are being considered to increase investigator availability. A 2014 exercise comparing casework numbers in Forensics with Forensic teams in other organisations was favourable in terms of numbers of cases with Oxford Health lying average/below average. This is an indicator only. Earlier in 2015 a number of people in both Human Resources and in the Services were trained in Mediation to provide a skill set that could help to avoid lengthy and often negative processes; the first mediation carried out by one of that cohort was successful. A proposal is being put to the Executive about how to best utilise this option. 15

Casework

Casework

CASEWORK 17

CASEWORK 17

CASEWORK Shows cases open at 09. 04. 15 by division by case type .

CASEWORK Shows cases open at 09. 04. 15 by division by case type .

Equality and Diversity Data Changes in % make-up are slight from 12 months ago:

Equality and Diversity Data Changes in % make-up are slight from 12 months ago: White – up 0. 5% Not stated up 0. 3% Asian – down 0. 1% Mixed down 0. 3% Other – down 0. 3% The disability make-up is also little changed No is up 0. 9% Yes – down 0. 1% and undisclosed down 0. 8% which is partly due to some data cleansing to attain more data. 19

Equality and Diversity Data • • • The age profile has shown little change

Equality and Diversity Data • • • The age profile has shown little change from 12 months ago. Changes are as follows: Under 30 up 1. 7% 30 -39 up 1. 8% 40 -49 - down 0. l% 50 -59 down 2. 9% 60 -69 up 0. 5% We have few under 20 s and the Apprenticeship programme plus work with schools is designed to address this. The largest group of staff are 40 -49; the profile has shifted slightly to have a slightly younger profile although 32. 5% of staff are over 50; and we are likely to see staff working for longer as the pensionable age (NHS pension aligned with state pension age) takes effect. The local population is growing. This is due to increased inward migration, particularly in the urban hubs of Oxford and Banbury, and the increasing life expectancy of the existing population, especially in the rural areas of the county. The mini baby boom of the past ten years which has seen numbers of children increasing year on year is forecast to level off. This will have the knock-on effect of having a smaller recruitment pool in future years. Competition for recruits will step up hence the work described above. 20

Friends and Family Test Results from the Q 4 Friends and Family test. The

Friends and Family Test Results from the Q 4 Friends and Family test. The test asks two questions: How likely are you to recommend OHFT to friends and family if they needed care or treatment? How likely are you to recommend OHFT to friends and family as a place to work? 989 staff responded to the on-line survey. The response rate was 18%, which is ahead of the national average of 16% and a significant improvement from Q 1 which saw a 6% response rate. Outcomes have varied little to those shown below for Q 4. 5 - Extremely unlikely 6 - Don't Know 7 - No Response "How likely are you to recommend this organisation to friends and family as a place to work" 4 - Unlikely "How likely are you to recommend this organisation to friends and family if they needed care or treatment" 3 - Neither likely nor unlikely 2 - Likely 1 - Extremely Likely 225 497 179 57 18 11 2 989 162 381 209 127 74 10 26 989 Total Oxon. Bikes All docks have now been installed at the three sites (Chancellor Court, Warneford and Littlemore). The bikes have been very well received by staff and we will receive a report next month showing how many staff have signed up and what journeys have been made. Demo sessions were held at each site to enable staff to sign up and try the bikes out and the scheme is proving to be very popular with staff already keen to expand the scheme to additional locations. 21

Occupational Health Activity Referral by Manager 117 IHR 0 Reviews 97 Self Referrals 14

Occupational Health Activity Referral by Manager 117 IHR 0 Reviews 97 Self Referrals 14 WHA 147 received WHA Appointments 53 Immunisations/blood test 285 BBV/NSI 21 Physiotherapy 23 Work Station assessments 3 Case Conferences 2 Triage 1540 appointments Total activities 2302 KPIs for April 2015: Of the 117 referrals 100% were offered appointments within the 10 day target. The average of days between date attended and date the report was dispatched was 1. 79 days, well within the 2 day target. The activities above exclude the following: • GP and Specialist request letters • Transfer of care or Urgent/immediate responses During April, of the 117 referrals 15 were MSK related and 16 stress related. Of the 15 MSK related referrals 3 were referred on for physiotherapy, 3 had been re-referred following completion of physiotherapy sessions and of the 16 stress related referrals 4 were referred on to the counselling service. Partnership with Older Peoples Directorate regarding the Fast track Physiotherapy pilot continues, with 56 referrals received. To date we have received 30 interim reports and 1 discharge report. Currently the MSK Physiotherapist is using a clinical room in the Occupational Health & Wellbeing Department and this is working well.

y ap er th io 0 ys 2 Ph ts en 3 em tir

y ap er th io 0 ys 2 Ph ts en 3 em tir re lth ts cs en nf er co se Ca en ts en ss m tm in se n as tio ea h Ill ta k s or po d ge 150 W ap HA W ria s t rm fo te 14 HA bi 50 W h/ as l st rra fe bl oo d te ick /s pl st le ed n/ tio sa un i re lf 300 Ne m Im 100 Se s w vie Re er ag an y m l b ra fe r Re Occupational Health Appointment reasons April 2015 285 250 200 147 117 97 53 21 23 0